TABLE 22 Proportion of Mothers Rated as Best in All Aspects of Child Care in Skilled Manual Workers' Families with Varying Numbers of Dependent Children, England, 1948-1950 Proportion of Mothers Number of Rated Best in All Dependent Aspects of Care Number of Children (Percent) Families 1 44.7 262 2 33.0 441 3 27.3 286 4 16.1 112 5 or more 10.1 80 Source: Douglas and Blomfield (25). cannot provide an adequate diet for her child with the money available. ... It is of interest that even in the professional and salaried group maternal care seems to become of importance in relation to the growth of fourth- or later-born children. With blackcoated workers it only becomes important after the first child, whereas with skilled manual workers it ceases to be important after the third. (33, italics theirs) The Aggravating Effects of Family Size In examining the data obtained in the study of preschool children in Candelaria (10), family size was one of several factors found to be associated with malnutrition. Some of the interactions between these factors were examined. The aggravating effect of increasing numbers of children became apparent when cross-correlations were made with some of the other factors associated with malnutrition. Initial analysis of the data, for example, had shown that malnutrition was more prevalent among the children of older mothers. This was rather surprising since we expected that older mothers, having learned from experience, might be more competent. When we controlled for family size, however, the reason became clear. The findings are shown in Table 23, where it may be seen that the prevalence of malnutrition in children of older mothers who have fewer children is well below the communitywide average. The problem in Candelaria is that most older mothers have numerous children and however competent they may be, they were unable to meet the needs of too many children, just as Douglas and Blomfield observed in England. We also found that children of literate mothers were less likely to be malnourished than those whose mothers were illiterate (38 percent mal-ssible that when a certain level of material prosperity is reached in the family the nutrition of the child is likely to be adequate whatever the capacity of the mother. Below a certain level, on the other hand, even the best managerpears, then, that larger families may be depriving themselves of medical care in order to meet other needs. No data are available to indicate whether the amount of free medical care received by low income families would alter this picture. However, free medical programs would not have any appreciable effect on families with incomes higher than $3,000 or $4,000 per year.